Individualizing Hormone Therapy to Minimize Risk

Accurate Assessment of Risks and Benefits

Donna Shoupe

Disclosures

Women's Health. 2011;7(4):475-485. 

In This Article

Prevention of Dementia & Alzheimer's Disease

A therapeutic window for protection from dementia and Alzheimer's disease is reported in a large number of studies.[39–45] As with cardiovascular disease, estrogen therapy initiated within 10 years of the menopause or in women <60 years of age has a higher benefit profile. Starting hormone therapy after 60–65 years needs to be done with caution. Use of a very low dose of hormone therapy and consideration of a transdermal administration is recommended.

In a prospective study in incident dementia among 1357 men and 1889 women (mean age around 73–74 years), the incidence among women increased after age 80 years and exceeded men of similar age. Women who used HRT had approximately a 50% reduction in risk (HR: 0.59; 95% CI: 0.36–0.96). Risk varied with years of use of hormones. Prior HRT use is associated with reduced risk of Alzheimer's disease, but there was no benefit with current HRT use unless such use had exceeded 10 years.[39]

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